CMO vs. MCO

Although a Care Management Organization (CMO) can assist with medical care management, CMOs are not the same as Managed Care Organizations (MCO).

Local CMOs are community-based, non-profit organizations that help New Jersey youth and their families with significant behavioral health needs.

MCOs provide assistance to families by connecting them with insurance benefits and service referrals for the appropriate support.

CMOs can assist families by requesting a review for potentially applicable services from MCOs, if this hasn’t happened already. After the service has been implemented, care managers from MCOs can help the Child Family Team (CFT) as a resource for any insurance or referral needs. 

CMOs Are Expected to Coordinate with MCOs

If a CMO is working with a child who is eligible for NJ FamilyCare, New Jersey’s publicly funded health insurance program, he or she will be assigned to the proper insurance program and will be prompted to choose an NJ FamilyCare Managed Care Organization that can assist the youth and family.  

Specialized programs are available to some youth, which CMOs will be aware of to provide coordination of care.

How MCOs Help Their Communities

Managed Care Organizations manage their members’ healthcare and offer additional services in addition to NJ FamilyCare Medicaid benefits. New Jersey’s Medicaid beneficiaries have greater access to healthcare providers and care coordination than they would have through the state’s fee-for-service program. 

Managed care health plans are also able to provide a comprehensive bundle of preventative health services, in addition to the full scope of Medicaid benefits, for the greatest healthcare possible.

Community-Based Care Management

NJCMO is here to help you find your local CMO. A resource for the families and communities in New Jersey, including CMO employees, NJCMO can assist with your questions. Contact us today to learn more.